International commitment for the introduction or scaling-up of sexual and reproductive health interventions has generally been insufficient to guarantee policy change and implementation at the national level, despite evidence for the effectiveness of such interventions. For sexual health in particular, political and legal frameworks nationally have been largely  determined by perceptions of cultural norms and moral standards. Such policies have met both passive and active resistance. We need to analyse the political dimensions associated with these policy processes, and to manage them strategically to counteract resistance to evidence-based policies from constituencies who might be more politically adroit.